Healthcare Provider Details
I. General information
NPI: 1578844247
Provider Name (Legal Business Name): SHERRI LYNN SWINEHART MA, LPC, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/07/2011
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
721 W CENTRE AVE
PORTAGE MI
49024-5309
US
IV. Provider business mailing address
721 W CENTRE AVE
PORTAGE MI
49024-5309
US
V. Phone/Fax
- Phone: 269-779-7577
- Fax: 269-888-2006
- Phone: 269-779-7577
- Fax: 269-888-2006
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 6401010135 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 6401010135 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 6801098756 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 6401010135 |
| License Number State | MI |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 6401010135 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: